The French law greatly expands access to abortions and also offers free and anonymous birth control to teenagers ages 15 to 18. France’s National Assembly passed the expansive abortion bill in October, and the legislation was approved by the Senate shortly thereafter.

The new law seeks to make abortion more easily attainable and offer free contraceptives to cut down on unwanted pregnancies. According to the French Directorate for Research, Studies, Evaluation and Statistics, 225,000 abortions were performed in France in 2010.

As Radio France Internationale notes, free access to birth control includes first and second generation contraceptive pills, along with contraceptive implants and sterilization. However, the law will not include other contraceptives, such as condoms.

Before the law was passed, France only offered to cover up to 80 percent of [the cost of] procedures to terminate pregnancies. Contraception costs were also partially refunded with reimbursements set at 65 percent. France provides remunerations for abortions and contraceptives through its social security funds.

BAKU, Azerbaijan – Women’s rights activists in Azerbaijan are worried about a proposal to ban abortions. The proposal was introduced by Hadi Rajabli, chairman of the Azerbaijani parliament’s social policy committee and a member of the governing Yeni Azerbaijan party.

“In many countries of the world, including China, Iran and Islamic states, abortion is regarded as murdering a human being. The destruction of unborn infants in their mothers’ wombs is not justified on humanitarian or religious grounds,” he said. “We therefore believe that such a ban could be introduced in Azerbaijan.”

Under current law, abortion is legal up to the 12th week of pregnancy, and under exceptional circumstances, until the 22nd week.

Azerbaijan, along with Armenia and Georgia, has historically had some of the highest abortion rates in the European region, according to the World Health Organization. Meanwhile, the use of modern contraceptives is low in these countries. This can be traced back to when Azerbaijan was part of the Soviet Union and contraceptives were not widely available. In fact, abortion was the most common form of birth control during the Soviet era.

Women’s rights advocates say that many women here are still unfamiliar with various means of contraception.

Matanat Azizova, head of the Women’s Crisis Center, believes the proposed ban would be disastrous. “There will be illegal abortions, causing death, sterility, various illnesses and so on,” she said. “It will also be a good way of fostering corruption, pregnant women will be able to pay doctors for a document stating that abortion is necessary on health grounds.”

The debate here has also been fueled by the issue of using abortion as a means of sex selection. The practice of terminating female fetuses has led to a significant imbalance in the country’s population, with 112 live male births to every 100 live female births. Azizova acknowledges that the problem exists, but says a blanket ban on abortions is no way to deal with the issue.

“International organizations have urged Azerbaijan to address the selective abortion problem which unfortunately exists here. But they (national authorities) have decided that the easiest route to fixing this is a ban, just so that they don’t have to think about it,” she said.

Ulviya Mammadova, a scholar at the Women’s Human Rights Training Institute in Azerbaijan and a well-known rights activist, also opposes a ban. “In practice, it will just create new problems, given the lack of social protections for women and low wages earned by young mothers,” she said. “Corruption and the lack of an effective health-care system will lead to illegal abortions at sky-high prices, with no way of holding doctors to account. There will be more abandoned children, and maternal mortality will increase.”

Only 20 of the 135 members of Azerbaijan’s parliament are female, and right activists like Mammadova worry that the concerns of women will not get a proper hearing if Rejebli’s proposal is adopted.

On the other hand, some young women, like Jamila Mammadova, 20 and a university student, are in favor of imposing a ban. “Termination of a pregnancy is a terrible sin,” she said. “I can’t see how this law will run into any problems with our customs and traditions.”

Islam, which plays a major role in Muslim-majority Azerbaijan, strictly forbids abortion. But some religious leaders, like Haji Ilgar Ibrahimoglu, imam of Baku’s Friday mosque and chairman of the Center for the Protection of Freedom of Conscience and Confession, say they are better ways of dealing with the issue than an outright ban.

“In countries like ours, bans are counterproductive and often result in the opposite of what was intended,” he said. “It will create an even greater tolerance of corruption, a rise in primitive forms of termination, an underground abortion industry, and protection rackets surrounding it.”

Women will soon be able to get the morning after pill delivered by courier to their home or office.

A new service will allow women to order emergency contraception on the internet, so it arrives within two hours, rather than having to see their GP to obtain the drugs.

Critics argue that it will encourage under age sex by making it too easy to obtain the morning after pill.

For £20, women will be able to order the drugs by filling out an online form through the internet medical practice DrEd.com.

The forms, which ask users to confirm they are aged over 18, will be assessed by doctors before pills are dispatched by courier.

Pills can be delivered within two hours on a normal working day, although it may also be possible for women to order online overnight for delivery the following morning.

Amit Khutti, founder of DrEd, said young girls would be deterred because dates of birth were requested during registration and patients needed a credit card.

He said: “I don’t think this service is going to appeal to minors or encourage under age sex.

“For a start, you need to pay for the service and if you’re young there are a number of places you can already get the morning after pill free.

“Emergency contraception works better the sooner you take it, so having it delivered within two hours will make it more likely to be effective.”

Mr Khutti said that previously the company could only offer emergency contraception in advance online because of problems ensuring it arrived in time to work – it is most effective within 36 hours of having sex.

He said: “It’s not ethical to provide a service that arrives too late.”

The courier service will begin in London this month but will be extended to other cities if it proves successful.

Mr Khutti added: “It will arrive at the office in discreet packaging so women won’t be embarrassed. Socially, some people are still put off by having to answer questions face to face about why they need emergency contraception.”

Norman Wells, from the Family Education Trust, said girls could easily lie about their age to access the pills and it should remain a prescription-only drug.

He said: “Since the morning-after pill was first approved for use in the UK, various schemes have been introduced to make it more widely and more easily available, yet the international research evidence continues to show that making it more readily available has not succeeded in reducing unintended pregnancy and abortion rates.

“Instead, young people in particular have been lulled into a false sense of security, take a more casual attitude to sex, and become exposed to an increased risk of sexually transmitted infections.”

Pharmacies already offer the morning-after pill over the counter for around £25.

In 2010/11 about 120,000 morning after pills were prescribed to reduce the workload of GPs.

The British Pregnancy Advisory Service has an online service which allows women to request emergency contraception and stock up in advance.

They speak to a nurse over the phone before it is delivered free of charge to their home.

Andrew Lansley, the Health Secretary, has previously criticised that scheme, saying he would prefer pills to be issued after a face – to – face consultations with medical professionals.

Catholic Hospitals Expand, Religious Strings Attached

Published: February 20, 2012

As Roman Catholic leaders and government officials clash over the proper role of religion and reproductive health, shifts in health care economics are magnifying the tension. Financially stronger Catholic-sponsored medical centers are increasingly joining with smaller secular hospitals, in some cases limiting access to treatments like contraception, abortion and sterilization.

Catholic hospitals have a broad mission for medical care, says Sister Carol Keehan, president of the Catholic Health Association.

In Seattle, Swedish Health Services has offered elective abortions for decades. But the hospital agreed to stop when it joined forces this month with Providence Health & Services, one of the nation’s largest Catholic systems.

In late December, Gov. Steve Beshear of Kentucky turned down a bid by Catholic Health Initiatives, another large system, to merge with a public hospital in Louisville, in part because of concern that some women would have less access to contraceptive services.

And in Rockford, Ill., there is resistance to a plan by OSF HealthCare, run by the Sisters of the Third Order of St. Francis, to buy a hospital because of new restrictions that would require women to go elsewhere if they wanted atubal ligation after a Caesarean section.

About 20 such deals have been announced over the last three years, by one estimate, and experts expect more as stand-alone hospitals and smaller systems with no Catholic ties look to combine with larger and financially stronger institutions, in part because changes under the federal health care law are forcing all hospitals to become much more efficient.

There is already considerable tension between Catholic-run medical institutions and the Obama administration over insurance coverage for contraception for employees. The cultural divide over reproductive health is playing out on the campaign trail as candidates debate hot-button issues like abortion and contraception.

But while the growth of Catholic-run hospital networks is a testament to their long history and operational skill, local and state officials, doctors and advocates in many communities are concerned that some procedures that run counter to Catholic doctrine may no longer be available or will be much more limited. Some doctors fear they may not be able to do what’s best for patients, forced to wait to treat a woman who is miscarrying, for example, or to send arape victim elsewhere for an emergency contraceptive.

The restrictions at any given hospital may not be clear. “Women simply don’t know what they’re getting,” said Jill C. Morrison, senior counsel in health and reproductive rights at the National Women’s Law Center.

The confusion is likely to increase.

“We are starting to see what was rare in the past,” said Lisa Goldstein, who follows nonprofit hospitals for Moody’s Investors Service and predicts more such partnerships. The institutions themselves are grappling with how to remain true to Catholic doctrine and serve a broader community. About one-sixth of all patients were admitted to a Catholic hospital in 2010. In many smaller communities, the only hospital within miles is Catholic.

“That is a constant challenge,” said Sister Carol Keehan, president of the Catholic Health Association of the United States, which represents the nation’s roughly 600 Catholic hospitals. “It’s a challenge we take very seriously.”

Being a Catholic hospital means adhering to the church’s religious directives about care, Sister Carol said, but she says hospitals also see their mission much more broadly, including caring for those who are less fortunate and treating patients with respect.

At the Seton Healthcare Family in Texas, a unit of Ascension Health — the nation’s largest Catholic system and largest nonprofit system — officials say partnerships with struggling community hospitals are integral to their mission. Seton’s first partnership, in 1995, was to operate Brackenridge, a public hospital in Austin, because Seton was “not doing enough to care for the poor and vulnerable in central Texas,” said Charles J. Barnett, an Ascension executive.

In that case, Mr. Barnett says the system never agreed to provide services like elective abortions and sterilizations, and public officials and hospital administrators initially struggled to find a compromise. Although another system eventually offered sterilizations on a separate floor of the hospital, complete with a separate elevator, another hospital now provides those services.

One large system, Catholic Healthcare West in San Francisco, announced in January that it was severing its formal ties to the church to better work with hospitals that did not share its faith. The system, renamed Dignity Health, operates 25 Catholic hospitals, which will remain Catholic, and 15 non-Catholic hospitals. While none of Dignity’s hospitals will provide elective abortions or offer in vitro fertilization, the non-Catholic hospitals will not have to adhere to the church’s religious directives.

Dignity officials declined interview requests.

Even as Catholic Healthcare West, however, the system was not without controversy. One of its Catholic hospitals performed what it considered a life-saving abortion in 2009, but the local bishop in Phoenix disagreed, and the nun who allowed the procedure was excommunicated.

In many communities, like Rockford, the question is an intensely practical one: How will patients, particularly women, use services barred by the church? Because none of the city’s three hospitals perform elective abortions, the debate has largely focused on whether a woman who has a C-section can have her tubes tied afterward.

“It would just be an inconvenience to the patient and the physician, who has to make life-and-death decisions,” said Dr. Ronald Burmeister, a retired obstetrician in Rockford who is concerned about the merger.

The merger itself was prompted by the increasing need for hospitals to combine. Despite the federal government’s concern about possible antitrust implications, many believe the city can support just two hospitals. “Rockford needed a strategic partner,” said Andrew K. Bachrodt, a managing director for Kurt Salmon Associates, which advises nonprofit hospitals. OSF already owns a Rockford hospital, OSF Saint Anthony Medical Center.

OSF says Rockford needs fewer hospitals and wants to expand its network to better serve the area. “It’s all about how to deliver care, coordinated and efficient care,” said Robert C. Sehring, an executive at OSF.

OSF has already developed an arrangement in which affiliated doctors can prescribe birth control pills through a separate practice.

A woman who wanted a tubal ligation immediately after a C-section would be able to go to a competing hospital, if her insurance plan allowed. “It’s not like we’re eliminating female sterilization procedures,” said Kris L. Kieper, the chief executive of the YWCA in Rockford, who serves on an advisory committee for the OSF hospital there.

In Louisville, the debate focused on contraceptive services, like elective sterilizations, that had been provided by the University of Louisville Hospital, one member of a planned three-party merger that would have created a large statewide system. There was considerable uncertainty over whether University Hospital would be required to follow Catholic policies, according to a report by the Kentucky attorney general. Officials initially said the hospital would follow Catholic directives but then focused on certain procedures.

“While this evolving explanation may represent an accurate description of the proposed legal structure of the consolidation, it has cast a cloud of vagueness and skepticism over the issue in the public eye,” the report concluded.

Asking women to go across town to another hospital for services is not a solution, said Dr. Peter Hasselbacher, a retired university official who follows health policy in Kentucky. And while women in Louisville generally have a choice of hospitals, women in rural communities may not, he said, adding that many of Catholic Health Initiative’s Kentucky hospitals are the only hospital available.

Catholic Health says there was never a possibility that University Hospital would be allowed to perform services like elective sterilizations. “Our position around the ethical and religious directives never changed. How we communicated that evolved and changed over time,” said Paul Edgett, a senior vice president at the system.

Mr. Edgett says the system will consider future partnerships with non-Catholic hospitals, including University Hospital, as it seeks to position itself as a stronger system as health care evolves. “We all have to adopt and adapt,” he said. But, he added, “we’re not going to compromise our values in the process.”

The Honduras Supreme Court has cemented the fate of women trying to avoid unintended pregnancy–whether from unprotected sex, contraceptive failure, or rape–by upholding what is currently the strictest ban on emergency contraception in the world. The absolute ban would criminalize the sale, distribution, and use of the “morning-after pill,” a contraceptive method that prevents pregnancy, by imposing punishment for offenders equal to that of obtaining or performing an abortion, which in Honduras is completely restricted. Emergency contraception is just that: contraception.

Anti-choice forces have, however, succeeded in confusing the method with an abortifacient despite a wealth of medical studies from around the globe that have shown it to be a safe, effective method of birth control which simply uses a higher dose of the same medication in typical birth control pills, and works by preventing an egg from being fertilized.

According to the Center for Reproductive Rights (CRR), currently, anyone who performs an abortion in Honduras can be sentenced anywhere from three to 10 years in prison, depending on if the woman consents or if violence and intimidation is a factor. Women who seek an abortion face three to six years in prison. With the court’s decision, simply being caught with an emergency contraceptive pill would be considered an abortion attempt.

These extreme bans on emergency contraception have been widely recognized by international and regional human rights bodies, like the Inter-American Commission on Human Rights, as violations of a woman’s ability to exercise her fundamental rights.

The Honduran Congress first passed the ban on EC in 2009, and then-President José Manuel Zelaya vetoed it a month afterward, immediately making the issue a matter for Supreme Court review. However, following the country’s June 2009 coup d’état, the de facto minister of health issued an administrative regulation in October 2009 banning emergency contraception, despite not yet having a ruling from the Supreme Court that would allow criminal enforcement of the ban. Nearly three years after the ban was vetoed by President Zelaya, today’s ruling now allows the Honduran Congress to impose the previously proposed criminal punishments on any medical professionals who distribute and sell emergency contraception and any woman who uses or attempts to use the medication to prevent an unintended pregnancy.

Not surprisingly, the Catholic Church has been heavily involved in limiting women’s reproductive rights and their options for essential health care. According to LatinoPoliticsBlog.com, “several prominent members of the de facto government in Honduras are members of the elitist, ultra-conservative Catholic Opus Dei movement, who were upset that ousted President Zelaya vetoed the ban” on emergency contraception.

According to CRR, up to half of sexually-active young women in Honduras, face obstacles to obtaining modern contraceptives — a statistic that is much higher for single women than married women and especially high among adolescent women. And LatinoPoliticsBlog.com notes that:

Honduras has the highest adolescent birthrate in Central America, and one half of women 20-24 give birth by the age of 20. Moreover, some 70% of the population lives in poverty and 40% of those live in extreme poverty. Early motherhood has been linked to extended poverty, higher infant mortality, and often perpetuates a lower standard of living as mothers have difficulty resuming school and focusing on occupational advancement. The availability of birth control and the morning after pill would help prevent unwanted pregnancies and allow Honduran women the opportunity to gain more education to better position themselves to provide for their families.

Access to emergency contraception can be a critical tool in preventing unwanted pregnancies — especially in countries where regular birth control can be difficult to obtain. But Women’s health, rights, and agency are not on the agenda of the church or the Honduran government.

“By banning and criminalizing emergency contraception, Honduras is telling the world it would rather imprison the women of its country than provide them with safe and effective birth control,” said Luisa Cabal, director of international legal programs at the Center for Reproductive Rights.

“Today’s decision from the Honduras Supreme Court blatantly disregards women’s fundamental reproductive rights and completely ignores the respected medical opinion of experts around the globe. It will cause significant harm in the lives countless women and doctors across the country.”

The irony of the coup government cracking down on women’s rights, states LatinoPoliticsBlog.com “is that it has sold itself as a defender of freedom.”

It certainly is a paradox for the de facto government to not allow women some privilege in exercising reproductive freedom and basic civil liberties, while presenting itself as democratic and paying hundreds of thousands of dollars to top US lobbyist and PR firms to build them an image that purports to be respectful of the rule of law. Secretary Clinton should seriously explore these rights violations before blessing the results of the upcoming Honduran election.

By Joyce Arthur

October 20, 2011Anti-choice activists in Canada argue that abortion should be defunded and that women should pay out-of-pocket for abortion care. But that is a right-wing ideological position that ignores evidence and human rights. Defunding abortion would be unconstitutional, discriminatory, and harmful to women. The following points explain why. (Each point is expanded upon here with detailed arguments, evidence and citations.)

1. Women’s lives and health are at stake. Funding abortion is necessary to guarantee women’s right to life and security of the person under the Charter of Rights and Freedoms. The main reason the Supreme Court threw out the old abortion law in 1988 was because it arbitrarily increased the risk to women’s health and lives through unnecessary delays and obstructed access. Not funding abortion would have the same effect and the same constitutional problems as the old abortion law, and would put politics and ideology ahead of women’s lives and health.

2. Women’s liberty and conscience rights under the Charter require abortion to be funded. The government must not interfere with the deeply personal decision to bear a child or not, which is integral to women’s autonomy and privacy. Otherwise, the government would be co-opting women’s right to choose by funding childbirth but not abortion, and paternalizing women with an official stance of moral disapproval of abortion.

3. Since only women need abortions, funding abortion is necessary to ensure women’s legal right to be free from discrimination. Restrictive policies and laws that apply to only one gender violate human rights codes that provide protection on the basis of sex. Further, women’s equality rights under the Charter cannot be realized without access to safe, legal, fully funded abortion—otherwise, women would be subordinated to their childbearing role in a way that men are not.

4. Abortion funding is crucial to ensure fairness and equity, without discrimination on the basis of income. We must not compel low-income women and other disadvantaged women to continue an unwanted pregnancy due to lack of funding, or to delay care while they try to raise money. Any delay in abortion care raises the medical risks, especially when it extends into the second trimester. Delays are also a punitive burden that unnecessarily prolong stress and discomfort for women. Best medical practice should ensure that abortion takes place as early as possible in pregnancy, and this requires full funding.

5. Funding abortion is very cost-effective while unwanted pregnancies are costly. The medical costs of childbirth are at least three times higher than the medical costs of abortion, and the social costs of forced motherhood and unwanted children are prohibitive. Further, the overall cost of abortion care to the taxpayer is a pittance relative to healthcare costs as a whole.

6. Funding abortion serves to integrate abortion care into the healthcare system in general, and ensure the comprehensiveness of reproductive healthcare programs, which is essential. If abortions were not funded, it would ghettoize abortion care, as well as the women who need it and the healthcare professionals who deliver it. This would likely increase stigma, lead to other restrictions, further marginalize abortion care over time, and increase anti-choice harassment and violence. All of this occurred in the United States after abortion was defunded for poor women by the 1973 Hyde Amendment.

7. Funding abortion is the right thing to do, despite some peoples’ belief that abortion takes a human life. There is no social consensus on the moral status of the fetus, and our laws do not bestow legal personhood until birth. Regardless, most Canadians believe that the woman’s rights are paramount in all or most circumstances, because she is the one taking on the health risks of pregnancy, bearing a child is a major decision with significant lifelong consequences, and a woman should be able to direct her own life and pursue her own aspirations apart from motherhood.

8. Legal abortion is very safe for women, and generally beneficial. The alleged medical and psychological “dangers” of abortion to women as described by anti-choice activists are either totally false or grossly overstated. Such arguments cannot support the defunding of abortion anyway, since pregnancy and childbirth are actually far more medically risky, and many other funded medical treatments carry substantial risk. Access to legal, safe, fully funded abortion is also beneficial for women and families because it allows them to continue with their lives and plan wanted children later when they are ready to care for them.

9. Opinion polls showing that a majority of voters do not want to pay for abortion are misleading and not pertinent. Voter opinion on this issue has been shaped by anti-choice misinformation, as well as lingering prejudice about women who have abortions. Regardless, voters have no authority to dictate what medical treatments to fund, as this is the role of provinces and medical groups. Women’s basic rights and freedoms must not be subject to a majority vote.

10. Abortion must be funded because it is not an elective procedure, any more than childbirth is. Pregnancy outcomes are inescapable, meaning that a pregnant woman cannot simply cancel the outcome—once she is pregnant, she must decide to either give birth or have an abortion. To protect her health and rights, both outcomes need to be recognized as medically necessary and fully funded, on an equal basis.

11. Anti-choice activists often say that “pregnancy is not a disease” and therefore abortion should not be funded. But the same arguments can be made for childbirth, since there are no medical reasons for a woman to get pregnant and have a baby. More importantly, health is much more than the absence of disease – it’s about achieving a state of overall health and wellness. Women with unwanted pregnancies are not in a healthy place, so their abortion care should be funded.

October 3 2011 at 12:10pm

SIPOKAZI FOKAZI

Health Writer

The number of abortions among women older than 18 has increased steadily in the Western Cape in the past two years, according to Health MEC Theuns Botha.

Responding recently in the legislature on the impact that illegal abortions have on public health care facilities, Botha said such abortions continued to take place, despite the service that was offered at more than 30 health care centres in the province.

While health care facilities had treated a number of women with complications arising from illegal abortions, Botha said it was difficult to say how many cases there had been as those known to the department were only of women who volunteered the information during treatment.

The department had, however, noted an increase in the number of women seeking the legal service.

In 2009, 13 172 abortions were performed in the province.

Last year, the number increased to 13 810.

Most of these, Botha said, were performed on women older than 18.

According to Marie Stopes, one of the largest private clinics specialising in reproductive health care, about 72 percent of women seeking termination of pregnancy were older than 18. Teenagers younger than 18 accounted for 5.8 percent.

Marie Stopes spokeswoman Leanne Visser said most women who sought abortions were aged between 18 and 30.

The clinic’s figures also showed a rise in the number of abortions it performed countrywide, from 46 644 in 2009 to 51 216 last year.

Between January 1 and May 31 this year, the clinic performed about 1 640 abortions.

In just more than 50 percent of the terminations, an abortion pill was used.

In cases where the pregnancy was between nine and 20 weeks, the abortion was performed surgically.

Abortions are performed free of charge in the public health care sector, but in the private sector the cost can range from R900 to more than R2 000.

According to the latest figures from the national Health Department, between 1997 – when legal termination of pregnancy was introduced – and last year, about 702 354 abortions were performed at public health care facilities nationwide.

About 528 000 of these involved teenagers.

Speaking during a Hospital Association of SA conference in Cape Town recently, Health Minister Aaron Motsoaledi expressed concern about the number of teenagers who were having abortions, describing the situation as “catastrophic”.

He said this was proof that young people were engaging in unprotected sex and risking HIV infection.

Part of what the National Health Insurance would introduce in the re-engineering of primary health care, Motsoaledi said, was a health programme in which nurses would provide reproductive health services at schools.

Visser said while the number of abortions might seem high, this should not be seen as a negative thing.

The increase was an indication that women were becoming more aware of their rights and options.

“The law allows for women to choose to terminate their pregnancy up to 20 weeks of gestation,” Visser said.

“The increase could be for a number of reasons. It could be that women feel more empowered to make such choices.”

Visser urged the authorities to be concerned rather about the number of illegal abortions that were being performed.

She called for more rigorous education to help teenagers make informed decisions.

She also called on parents and teachers to talk openly about contraception methods and the correct use of and access to contraception.

“Research shows that a large majority of pregnant teenagers are in poor communities where educational and financial opportunities are limited.

“Women need to be made aware that contraception is a method to prevent pregnancy, and that abortion is not a form of contraception.”

Marion Stevens, co-ordinator of Women in Sexual and Reproductive Health, said there was a need for a widespread use of abortion pills, otherwise known as medical abortion, rather than the surgical option.

In the Western Cape, the abortion pill was available only at the Khayelitsha clinic.

Botha said the fact that illegal abortions continued to take place pointed to deficiencies in the system, including a lack of access to clinics.